This grant would support the development of the research infrastructure, including data bases, research methodologies, and collaborative working relationships that will provide the foundation for ongoing, sustainable research and effective strategies for addressing the significant health issues of American Indians in Montana and Wyoming. In addition to the Institutional Research Infrastructure Development that is a major component of this application; two individual investigator research studies will be conducted. The first focuses on research to identify factors affecting breast and cervical cancer screening and follow-up of abnormal findings and development and implementation of a pilot program to increase the proportion of American Indian women who receive screening tests. The second research study designs and tests a methodology for reporting results of a survey of American Indians eligible to use IHS services that collects information on their experiences and satisfaction with process and experiences with health care. The objective of the project is to design, implement, and evaluate the effectiveness of a structured process involving Tribal members and IHS managers and providers to jointly develop strategies for performance improvement based on priority issues that are identified through the consumer survey. The Montana-Wyoming Tribal Leaders Council, Black Hills State University, and the Black Hills Center for American Indian Health (MT-WY TLC, BHSU, and BHCAIH) have developed an innovative partnership approach to respond to the AHRQ Minority Research Infrastructure Support Program Request for Applications. The specific goals of this grant include: 1) establishment of the research infrastructure necessary for conduct of ongoing minority health research, evaluation, and programs; 2) development of a targeted research agenda, addressing Tribally identified priority health issues; and development of capacity within the MT-WY TLC, BHSU, and BHCAIH to implement this research agenda; and 3) development of effective collaborative relationships between the Tribes and the three organizations that will form the basis for a long-term partnership for joint research programs to identify, assess, and implement strategies that address health issues of American Indians.